<!DOCTYPE html>
<html>
	<head>
		<meta charset="utf-8">
		<title>菜品管理页面</title>
		<link rel="stylesheet" type="text/css" href="static/dist/css/zui.min.css" />
	</head>
	<body>
		<div class="container" style="margin-top: 30px;">
			<div class="panel">
				<div class="panel-heading" style="text-align: center;">
					健康信息
				</div>
				<div class="panel-body">
                    <div class="modal-dialog">
                        <div class="modal-content">
                            <div class="modal-header">
                                <button type="button" class="close" data-dismiss="modal"><span aria-hidden="true">×</span><span class="sr-only">关闭</span></button>
                                <h4 class="modal-title" style="text-align: center;">新增健康信息</h4>
                            </div>
                            <div class="modal-body container">
                                <form class="form-horizontal">

                                    <div class="form-group col-xs-12 with-padding">
                                        <label class="col-xs-2 required">姓名</label>
                                        <div class="col-xs-10">
                                            <input type="text" name="" class="form-control" id="name" value="" placeholder="请输入姓名" />
                                        </div>
                                    </div>

                                    <div class="form-group col-xs-12 with-padding">
                                        <label class="col-xs-2 required">手机号码</label>
                                        <div class="col-xs-10">
                                            <input type="text" name="" class="form-control" id="phone" value="" placeholder="请输入手机号码" />
                                        </div>
                                    </div>

                                    <div class="form-group col-xs-12 with-padding">
                                        <label class="col-xs-2 required">证件类型</label>
                                        <div class="col-xs-10">
                                            <!--card_type-->
                                            <select id="cardType" class="form-control"></select>
                                        </div>
                                    </div>


                                    <div class="form-group col-xs-12 with-padding">
                                        <label class="col-xs-2 required">证件号码</label>
                                        <div class="col-xs-10">
                                            <input type="text" name="" class="form-control" id="cardCode" value="" placeholder="请输入证件号码" />
                                        </div>
                                    </div>



                                    <div class="form-group col-xs-12 with-padding">
                                        <label class="col-xs-2 required">近期居住地</label>

                                        <div class="col-xs-10">
                                            <!--card_type-->
                                            <select id="province" onchange="chooseProvince(this)">
                                                <option>---请选择省---</option>
                                            </select>

                                            <select id="city" onchange="chooseCity(this)">
                                                <option>---请选择市---</option>
                                            </select>

                                            <select id="area">
                                                <option>---请选择区---</option>
                                            </select>
                                        </div>
                                        <!--<div class="col-xs-10">-->
                                            <!--<input type="text" name="" class="form-control" id="address" value="" placeholder="请输入居住地址" />-->
                                        <!--</div>-->
                                    </div>

                                    <div class="form-group col-xs-12 with-padding">
                                        <label class="col-xs-2 required">详细地址</label>
                                        <div class="col-xs-10">
                                            <input type="text" name="" class="form-control" id="addressDetail" value="" placeholder="请输入详细地址" />
                                        </div>
                                    </div>

                                    <div class="form-group col-xs-12 with-padding">
                                        <label class="col-xs-2 required">体温情况</label>
                                        <div class="col-xs-10">
                                            <!--card_type-->
                                            <select id="temperature" class="form-control"></select>
                                        </div>
                                    </div>

                                    <div class="form-group col-xs-12 with-padding">
                                        <label class="col-xs-2 required">来粤说明</label>
                                        <div class="col-xs-10">
                                            <input type="text" name="" class="form-control" id="guangdong" value="" placeholder="请输入来粤说明" />
                                        </div>
                                    </div>


                                </form>
                            </div>

                            <div class="modal-footer">
                                <button type="button" class="btn btn-default" data-dismiss="modal">关闭</button>
                                <button id="btnInsertSubmit" type="button" class="btn btn-primary">保存</button>
                            </div>
                        </div>
                    </div>

				</div>
			</div>
		</div>

	</body>
	<script src="static/dist/lib/jquery/jquery.js" type="text/javascript" charset="utf-8"></script>
	<script src="static/dist/js/zui.min.js" type="text/javascript" charset="utf-8"></script>
	<script src="static/layer/layer.js" type="text/javascript" charset="utf-8"></script>
	<script src="static/js/food_mgr.js" type="text/javascript" charset="utf-8"></script>

    <script type="text/javascript">

    </script>
</html>
